Abnormal eating attitude test scores predict menstrual dysfunction in lean females

The role of subnormal nutrition and subclinical anorexia nervosa as factors associated with menstrual dysfunction in lean females has not been defined. We studied the relationship between elevated scores for the Eating Attitudes Test (EAT) and the Eating Disorders Inventory (EDI) and menstrual dysfunction in 88 predominantly lean female marathon runners, ballet dancers, and fashion models. For analysis, the subjects were categorized according to their weight classification and exercise status into low-mass nonexercisers, low-mass exercisers, and moderate-mass exercisers. Menstrual dysfunction was equally common in all groups (43–55%); the incidence of elevated EAT and EDI scores was high in all groups (15–65%). Elevated EAT test scores, but not body mass or exercise, were associated with menstrual dysfunction (p = 0.009). Subnormal nutrition may be the critical yet unrecognized factor explaining menstrual dysfunction in lean women.